Thyroid profile Total

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    Thyroid Profile Total (3 tests)

    • Thyroid Stimulating Hormone (TSH)
    • Thyroxine - Total (T4)
    • Triiodothyronine Total (T3)

    • What is Thyroid profile Total?

      The Thyroid Profile Total is a group of tests that are done together to detect or diagnose thyroid diseases. It measures the levels of the following three hormones in the blood: Thyroid Stimulating Hormone (TSH), Thyroxine (T4) - Total and TriIodothyronine (T3) - Total.

      Why is Thyroid profile Total done?

      The Thyroid Profile Total test is done:

      • To diagnose any suspected thyroid disease (Hypothyroidism or Hyperthyroidism)

      • To monitor treatment in patients with thyroid diseases

      • To investigate the cause of infertility



      What does Thyroid profile Total Measure?

      The Thyroid Profile Total test measures the levels of the following three hormones in the blood:
      Thyroid Stimulating Hormone (TSH)
      Thyroxine (T4) - Total
      TriIodothyronine (T3) - Total

      The thyroid gland (a small, butterfly-shaped gland located in front of the neck) secretes the following hormones:

      • Triiodothyronine (T3)

      • Thyroxine (T4)

      Thyroid Stimulating Hormone (TSH), also called Thyrotropin is a hormone secreted into the blood by the Pituitary gland (a gland present in the brain)). It tells your thyroid gland to make and release the thyroid hormones (T3 & T4) into your blood. The thyroid gland uses the iodine gained from food to make the thyroid hormones.

      The thyroid hormones are essential for growth and metabolism. If the thyroid gland produces very high amounts of T3 and T4 hormones, you may experience symptoms like weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity to heat, etc. and this is known as Hyperthyroidism.

      The decreased production of thyroid hormones (T3 and T4) results in Hypothyroidism which may lead to weight gain, fatigue, slow heart rate, increased sensitivity to cold, depression, dry and thin hair, etc.

      There is a feedback system in the body to maintain stable amounts of the thyroid hormones (T3 and T4) in the blood. When the levels of thyroid hormone decrease, the pituitary gland is stimulated to release TSH.  High TSH in turn increases the release of T3 and T4 thyroid hormones from the thyroid gland and vice-versa.

      T3 and T4 circulate in the blood in two forms:

      1) Bound form - It is bound to proteins present in blood and this prevents it from entering the body tissues. The three main proteins in the blood that the thyroid hormones are bound to are albumin, transthyretin and Thyroxine-binding globulin (TBG), also called Thyroid hormone Binding Globulin (THBG).

      2) Free form - It enters the body tissues where it is  needed

      The total T3 or total T4 includes both bound and free forms circulating in the blood. Hence, thyroid hormones can be measured as Free T3, Total T3, Free T4, and Total T4.

      The total T3 and total T4 levels can be affected by the amount of protein available in the blood to bind to them.


    TSH levels show circadian variation (fluctuates during the 24-hour cycle), reaching peak levels between 2 - 4 am and are at a low between 6-10 pm.

    • Interpreting Thyroid profile Total results


      Interpretations



      T3 (Triiodothyronine), Total                 Reference Range(s)





      <1 Month

      Not established


      1-23 Months

      117-239 ng/dL



      2-12 Years

      105-207 ng/dL



      13-20 Years

      86-192 ng/dL



      >20 Years

      76-181 ng/dL




      T4 (Thyroxine), Total

                                                       4.5-12.0 mcg/dL


      Thyroid Stimulating Hormone (TSH)               Reference Range(s)

      Premature Infants (28-36 Weeks)

       1st Week of Life

      0.20-27.90 mIU/L

      Term Infants (>37 Weeks)

       Serum or Cord Blood

      1.00-39.00 mIU/L

       1-2 Days

      3.20-34.60 mIU/L

       3-4 Days

      0.70-15.40 mIU/L

       5 Days-4 Weeks

      1.70-9.10 mIU/L

       1-11 Months

      0.80-8.20 mIU/L

       1-19 Years

      0.50-4.30 mIU/L

       ≥20 Years

      0.40-4.50 mIU/L

      Pregnancy

       First Trimester

      0.26-2.66 mIU/L

       Second Trimester

      0.55-2.73 mIU/L

       Third Trimester

      0.43-2.91 mIU/L

        Table 1. Interpretation of the Thyroid Profile Test results

        TSH

        T4

        T3

        INTERPRETATION

        Elevated

        Normal

        Normal

        Mild (subclinical) hypothyroidism

        Elevated

        Low

        Low or normal

        Hypothyroidism

        Low

        Normal

        Normal

        Mild (subclinical) hyperthyroidism

        Low

        Elevated or normal

        High or normal

        Hyperthyroidism

        Low

        Low or normal

        Low or normal

        Nonthyroidal illness; hypothyroidism due to the disease involving the pituitary gland

        Normal

        Elevated

        Elevated

        Thyroid hormone resistance (Impaired sensitivity to thyroid hormone)

      • Low T4 and T3 along with high TSH level indicates hypothyroidism. The most common cause of hypothyroidism is Hashimoto thyroiditis 
      • High T4 and T3 along with low TSH indicate hyperthyroidism. The most common cause of hyperthyroidism is Grave’s disease
      • Normal thyroxine (T4) and T3 along with high TSH usually indicates mild or subclinical hypothyroidism 
      • Normal T3 and T4 along with low TSH indicates mild or subclinical hyperthyroidism 


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